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General NPI Number Information
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NPI Number | 1700049327
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Entity Type | Organization
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Legal Business Name | MM PLASTIC SURGERY PLLC
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Dates
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Enumeration Date | 07/03/2008
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Last Update Date | 04/07/2009
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Provider Practice Location Address
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Address Line | 3170 N SWAN RD
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City | TUCSON
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State | AZ
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Zip | 85712-1227
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Country | US
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Telephone | 520-298-2325
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Fax | 520-298-2328
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Provider Business Mailing Address
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Address Line | 1951 N WILMOT RD BLDG 2
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City | TUCSON
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State | AZ
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Zip | 85712-8000
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Country | US
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Telephone | 520-750-7166
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Fax | 520-886-1929
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Authorized Official
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Title or Position | MD
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Name | BRANDON MASSEY
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Credential | MD
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Telephone | 520-298-2325
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number |
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License Number State |
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